尺神经损伤402例报告

Management of ulnar nerve injuries: A report of 402 cases

目的介绍尺神经损伤的治疗方法和疗效。方法４０２例尺神经损伤，上臂４４例，肘部６１例，前臂１３８例，腕部１３４例，掌部２５例。完全断伤３１２例，部分断伤２２例，神经粘连６８例。行神经松解术７２例，神经直接缝合２８６例，束组束膜缝合３１例，神经移植１３例。结果按顾玉东的低位神经功能评定标准评定，优１１７例，占２９．１％，良１３４例，占３３．３％，可１０５例，占２６．１％，差４６例，占１１．５％；总优良率为６２．４％。二期行功能重建术２２例。结论尺神经损伤后行神经缝合或粘连松解术后疗效较好。如因各种原因导致不可逆性损伤则应积极地进行功能重建术，如蚓状肌骨间肌重建术、第一背侧骨间肌重建术和小指内收功能重建术，以恢复手的精细功能。

Objective To present the methods and results of treatment for ulnar nerve injuries. Methods 402 cases of ulnar nerve injuries were treated, of which 330 with neurorrhaphy or nerve grafting and 72 with neurolysis. The level of injury was: 44 in the arm, 61 at the elbow, 138 in the forearm, 134 at the wrist and 25 at the palm. The patients were followed up for an average of 4.5 years and assessed by Gu's standard for their hand function. Results Assessment of ulnar nerve function revealed excellent results in 117 cases (29.1%), good in 134 (33.3%), fair in 105 (26.1%), and poor in 46 (11.5%) . Second stage functional reconstruction of the intrinsic muscles were done in 2 cases. Conclusions Generally satisfactory results can be obtained by nerve repair or neurolysis in ulnar nerve injuries. Functional reconstruction however should be carried out in case of irreversible palsy.